ABSTRACTS
Training for Prevention: Improving Paramedic Confidence in Fall RiskAuthor: Jeffrey Rollman MPH, NRP | Health Educator | Center for Prehospital Care, Department of Emergency Medicine, UCLA David Geffen School of Medicine Associate Authors: Sylvia, Jameel, MPA, NRP
Background Falls are a leading cause of injury and 911 utilization among older adults. Paramedics and other emergency medical services (EMS) clinicians frequently respond to lift assists and fall-related calls, yet receive limited or no formal training in fall risk assessment, intervention, or prevention strategies. Targeted education, including EMS-specific adaptations of existing fall prevention toolkits, may enhance EMS engagement in upstream prevention. Our objective was to assess pre/post changes in knowledge, beliefs, and abilities among paramedics following a brief fall prevention training. Methods We conducted a one-hour interactive training session during a four-day in-person paramedic refresher course. This training incorporated the CDC’s evidence-based STEADI fall prevention algorithm, covering fall-related epidemiology, medical causes of falls, prehospital risk screening, home hazard recognition, and EMS referral pathways. Five-point Likert agreement items were assessed before and after the session. Given the anonymous responses, pre/post means were compared using independent t-tests with α=0.05, with Wilcoxon rank sum also used to compare pre/post medians to ensure robustness of our findings. Results Of 37 paramedics who completed the course, 28 (75.7%) completed both pre- and post-surveys. Improvements were observed across all domains. Confidence in assessing fall risk rose from 3.64 to 4.39 (p = 0.002), and confidence in referring patients increased from 3.90 to 4.44 (p = 0.105). Belief in EMS-led prevention (4.21 to 4.50, p = 0.157) and understanding of medical causes of falls (3.93 to 4.29, p = 0.087) also improved, though not significantly. Agreement that “Falls and lift assists are a major problem for my primary EMS agency” increased from 2.79 to 4.07 (p < 0.001). Wilcoxon tests confirmed these findings. Among paramedics without active fall prevention programs in their agencies, 16 of 18 (89%) agreed or strongly agreed that such a program would be beneficial for their EMS agency. Conclusion A brief, interactive training session significantly improved paramedic awareness of fall-related burden and confidence in performing fall risk assessments. Our findings support the feasibility and potential value of incorporating fall prevention content into continuing education for paramedics. Broader implementation could enhance EMS engagement in proactive care and injury prevention for older adults.
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